Paediatric dentistry

  1. All hail the Hall
In this study 180, 5-8-year-old children, each of whom had one carious primary molar were treated by a dental therapist with a either a plastic restorative material (PRM) or a pre-formed stainless steel crown placed with the Hall Technique (HT). After 2 years, outcomes were categorised as success, minor failure, or major failure. A total of 147 (82%) children were followed up for a mean period of 25 months. Failure was observed significantly more in the PRM group (32%) than the HT group (6%). When baseline carious lesions were radiographically deep with marginal ridge breakdown (MRB), there was a higher proportion of major failures than when the cavities were shallow and without MRB (33% and 1%, respectively). Among the deep lesions, those treated with the HT showed better success than PRM. Overall, there was a much higher success rate in the children treated with HT than PRM and, additionally, deep carious lesions responded better to HT than PRM.

Boyd DH, Page LF, Thomson WM. The Hall Technique and conventional restorative treatment in New Zealand children’s primary oral health care - clinical outcomes at two years. Int J Paediatric Dent 2017 Aug 08.

Q The Hall Technique:
A Involves the use of pre-formed stainless steel crowns
B Shows greater long-term success than other restorative materials
C Is more successful with deeper caries lesions
D All of the above

  1. Parental guilt uncovered
Do parents feel guilty about their children’s oral problems and if so, is this associated with socio-economic, demographic, and psychological factors? Included in the study aiming to answer these questions were 1,313 parent-and-child pairs in which the children were 2-4 years old. Parents answered questionnaires on socio-economic and demographic data, and on psychological variables and dentists examined the children for oral hygiene (the presence and absence of plaque), early childhood caries (ECC; no caries, low and high severity), malocclusion (presence and absence), and traumatic dental injuries (TDI; presence and absence). Examination revealed 26.3% of children had caries, 39.8% malocclusion, 22.9% TDI; 24% of parents reported feeling guilty. Of these, 54% thought that their children had problems in their teeth, and most of them (82%) thought that the problem could have been avoided. The feeling of guilt in parents was significantly associated with ECC and the psychological variables: the thought that the child had problems in his/her teeth and the thought that the problem could have been avoided.

Carvalho TS et al. Early childhood caries and psychological perceptions on child's oral health increase the feeling of guilt in parents: an epidemiological survey. Int J Paediatric Dent 2017 May 17.

Q Which form of oral problems did parent feel most guilty about in their children?
A Malocclusion
B Traumatic injuries
C Early Childhood Caries
D Poor oral hygiene

  1. Oscillating rotating from the start
This research compared the plaque removal of power toothbrushes versus manual toothbrushes in a paediatric population as clinical investigations of this in children are limited. The children were randomly assigned to a treatment sequence involving an oscillating-rotating power toothbrush and a manual toothbrush control, brushing under supervision with a sodium fluoride toothpaste. Plaque was assessed pre- (baseline) and post-brushing using the Turesky Modification of the Quigley-Hein Plaque Index by two examiners. Plaque scores were averaged for mixed and permanent dentition for each child and analysed. Forty-one subjects (mean age 9.0 years) were randomised and completed the trial. Both the power brush and manual brush provided statistically significant mean plaque reductions versus baseline in all forms of analyses but with both examiners, plaque removal was significantly greater for the power brush in permanent and mixed dentitions. The interexaminer correlations for the permanent dentition were strong for pre-brushing plaque across all periods. An oscillating-rotating power toothbrush provided superior plaque reduction versus a manual toothbrush in children.

Davidovich E et al. Randomised clinical study of plaque removal efficacy of a power toothbrush in a paediatric population. Int J Paediatric Dent 2017 May 11.

Q An oscillating-rotating power toothbrush:
A Provided superior plaque removal reduction in children compared to a manual brush
B Provided worse plaque removal reduction in children compared to a manual brush
C Provided an equal plaque removal reduction in children compared to a manual brush
D Is not available for use by children

  1. Passing it on
The purpose of this study was to evaluate Streptococcus mutans strains (genotypes - GT) between mother and child (M-C) in a high caries risk cohort to explore the association with early childhood caries (ECC). Sixty-nine infants (each approximately one year old) had periodic oral examinations for caries (dmfs) and microbial samples collected from dental plaque, saliva, and other oral surfaces. Their mothers had an examination and plaque collected. S mutans samples were tested for similarities and statistical analyses were conducted for associations between mother and child. Twenty-seven S mutans strains (GT) from 3,414 samples were identified. Colonisation of children with Streptococcus mutans genotypes that matched with their mother’s strain was shown to be highly associated with ECC. Although the results suggest direct transmission of S mutans in 40 of 69 children that shared GT with their mother, it is possible that other individuals transmitted the S mutans. Nonetheless, these findings support the importance of the mother’s oral microbial status as a contributing influence to their children’s oral health.

Childers NK et al. Association between early childhood caries and colonization with streptococcus mutans genotypes from mothers. Pediatric Dent 2017 39: 130-135.

Q On the basis of these results do you think that?
A A mother is quite likely to transfer the microbiological risk of caries to her child
B It is not possible for a mother to pass on her strain of S mutans to he child
C A child’s dental health is not at all dependent on her or his mother’s
D S mutans is passed mainly from child to mother